MEDICARE: HEALING HANDS HOMECARE SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1578079380
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALING HANDS HOMECARE SERVICES LLC

Provider Business Mailing Address
First Line	:	5641 BURKE CENTRE PKWY STE 111
Second Line	:
City	:	BURKE
State	:	VA
Zip	:	22015-2259
Country	:	US
Telephone Number	:	571-635-7767
Fax Number	:	571-418-0110

Provider Business Practice Location Address
First Line	:	5641 BURKE CENTRE PKWY STE 111
Second Line	:
City	:	BURKE
State	:	VA
Zip	:	22015-2259
Country	:	US
Telephone Number	:	571-635-7767
Fax Number	:	571-418-0110

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	JOYCE ROTICH
Credential	:
Telephone Number	:	571-635-7767

Provider Enumeration Date	:	12/18/2017
Last Update Date	:	11/09/2020

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